ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title The Use of Aloe Vera Mouthwash in a Healthy Adult Patient Does Effectively Reduce Plaque Index
Clinical Question In a healthy adult patient, does the use of Aloe Vera mouthwash effectively reduce plaque index as compared to no treatment?
Clinical Bottom Line For healthy adult patients, the use of Aloe Vera mouthwash effectively reduces plaque index as compared to no treatment. Aloe Vera mouthwash has proven to be an effective anti-plaque agent and can be used as a possible affordable herbal substitute for Chlorhexidine, as well as having fewer side affects. This is supported by two randomized controlled trials and is within the capability of the average general dental practice and likely to be accepted by the average patient.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24603910Karim/2014345 healthy subjectsRandomized Controlled Trial
Key resultsMean plaque and gingivitis scores showed statistically significant differences between the Aloe Vera and the placebo group and between the Chlorhexidine and the placebo group (P <.05). Chlorhexidine showed the largest decrease but there was no statistically significant difference between the Clorhexidine group and the Aloe Vera group when compared to each other (P >.05).
#2) 23493442Chandrahas/2012120 healthy subjects age 18-25Randomized Controlled Trial
Key resultsSubjects received a specially fabricated plaque retainer to prevent removal of plaque in the experimental areas to and be worn until the time that the mouthwash was given (day 0-14). Both the Aloe Vera Group and the Chlorhexidine group when compared to the placebo group had a statistically significant decrease in plaque index, gingival index and bleeding index (day 15-22) after the mouthwash had been distributed (P<.05). Mouthwash containing Aloe Vera showed significant reduction of plaque and gingivitis but when compared with Chlorhexidine the effect was borderline statistically significant (P =.05). However when comparing effectiveness of Aloe Vera mouthwash to Chlorhexidine to gingival index and bleeding index was much less significant (p<.05).
Evidence Search ("aloe"[MeSH Terms] OR "aloe"[All Fields] OR ("aloe"[All Fields] AND "vera"[All Fields]) OR "aloe vera"[All Fields]) AND ("mouthwashes"[Pharmacological Action] OR "mouthwashes"[MeSH Terms] OR "mouthwashes"[All Fields] OR "mouthwash"[All Fields]) AND ("dental plaque index"[MeSH Terms] OR ("dental"[All Fields] AND "plaque"[All Fields] AND "index"[All Fields]) OR "dental plaque index"[All Fields] OR ("plaque"[All Fields] AND "index"[All Fields]) OR "plaque index"[All Fields])
Comments on
The Evidence
Validity: In Karim's article, three groups of healthy adults were studied, all of which were randomly computer generated selected and blinded to the type of mouthwash used. The Placebo group was the negative control and the Aloe Vera group being the test group and the Chlorhexidine used as a known clinical comparison. A single blinded examiner was used to record all patients’ indexes. Patients were treated the same (besides the difference in mouthwash given) and started out the same, and all patients who did not meet standard of a healthy patient (smokers, patients with dental work in the past 3 months, patients with systemic disease), were eliminated from the study before the start. All subjects were given the same oral hygiene instructions (sometimes supervised, sometimes not), and all study groups completed the study so no attrition was noted. In Chandrahas’s article, the exclusion of patients such as smokers, those with pocket depths greater than 3 mm and/or antibiotic use in the past 3 months was incorporated to make the patient groups similar to one another for the study. All subjects were treated equally from the start and instructed to complete the same oral hygiene protocol throughout the study (except for the use of the tested mouthwash agent). All subjects and recorders were blinded. Perspective: The result of these treatment studies for the use of Aloe Vera Mouthwash appears to be very promising. While there are limited studies in this subject, these articles have shown high Validity towards the topic being researched. The results in these studies provide significant results that would indicate positive clinical effects for the use of Aloe Vera as an effective means of reducing plaque and gingivitis. However more studies are needed to provide more significant evidence in how Aloe Vera compares to Chlorhexidine in its measure on extent of effectiveness. And more studies need to be provided about patients with Aloe Vera Mouthwash and the effects on periodontally compromised patients.
Applicability Any patient looking for alternatives to traditional mouthwash, or an affordable herbal substitute for Chlorhexidine with less side affects. Aloe Vera mouthwash has proven to be an effective antiplaque agent and is within the capability of the average general dental practice and likely to be accepted by the average patient.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Aloe Vera, mouthwash, plaque index
ID# 3070
Date of submission: 03/22/2016spacer
E-mail Lorren@livemail.uthscsa.edu
Author Talena Lorren
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie Jones, DDS, MBA
Faculty mentor/Co-author e-mail jonesa@uthscsa.edu
Basic Science Rationale
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